Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK

Sobha Sivaprasad, Nachiketa Acharya, Phil HykinMoorfields Eye Hospital, London, UKAbstract: The pathogenesis of age-related macular degeneration (AMD) is unclear, but it can take either a neovascular/exudative/wet form, characterized by choroidal neovascularization (CNV), or a dry form. No treatment...

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Autores principales:	Sobha Sivaprasad, Nachiketa Acharya, Phil Hykin
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5387f5b853cd417881facd7c3d727cf5
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spelling	oai:doaj.org-article:5387f5b853cd417881facd7c3d727cf52021-12-02T01:35:51ZPegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK1177-54671177-5483https://doaj.org/article/5387f5b853cd417881facd7c3d727cf52008-06-01T00:00:00Zhttp://www.dovepress.com/pegaptanib-sodium-for-neovascular-age-related-macular-degeneration-cli-a1790https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Sobha Sivaprasad, Nachiketa Acharya, Phil HykinMoorfields Eye Hospital, London, UKAbstract: The pathogenesis of age-related macular degeneration (AMD) is unclear, but it can take either a neovascular/exudative/wet form, characterized by choroidal neovascularization (CNV), or a dry form. No treatments are available for the dry form, but there are a number of pharmacological interventions that inhibit vascular endothelial growth factor (VEGF), which is central to the pathogenesis of CNV and neovascular AMD. Available anti-VEGF agents either target all active VEGF isoforms (eg, ranibizumab), or take a more selective approach and inhibit only VEGF165 (eg, pegaptantib sodium). Current guidance on their use is equivocal and restrictive at best, resulting in associated difficulties in securing adequate, timely funding for treatment. The Moorfields Eye Hospital undertook an audit of 70 patients receiving intravitreal (ITV) pegaptanib sodium on a pro re nata (prn) dosing schedule. Despite initial funding delays, the audit recorded superior treatment outcomes compared with those reported in the VISION trials at 12 weeks: 88% of audit patients maintained stable vision, 29% gained vision and 6% experienced severe vision loss compared with 70%, &ge;6% and &le;10% of patients in VISION at 54 weeks, respectively. The audit indicates a positive correlation between patients with better baseline visual acuity (VA) and improved therapeutic benefits, including a greater likelihood of both vision gain and vision preservation. Experience at Moorfields also suggests that pegaptanib sodium is more useful in occult lesions than minimally classic lesions, and clinical experience suggests that combination therapies may offer the best approach with anti-VEGF therapies. Further randomized clinical trials will help better determine the optimal treatment strategies with pegaptanib sodium in neovascular AMD.Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, pegaptanib sodium, visual outcomes, funding Sobha SivaprasadNachiketa AcharyaPhil HykinDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 347-354 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sobha Sivaprasad Nachiketa Acharya Phil Hykin Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
description	Sobha Sivaprasad, Nachiketa Acharya, Phil HykinMoorfields Eye Hospital, London, UKAbstract: The pathogenesis of age-related macular degeneration (AMD) is unclear, but it can take either a neovascular/exudative/wet form, characterized by choroidal neovascularization (CNV), or a dry form. No treatments are available for the dry form, but there are a number of pharmacological interventions that inhibit vascular endothelial growth factor (VEGF), which is central to the pathogenesis of CNV and neovascular AMD. Available anti-VEGF agents either target all active VEGF isoforms (eg, ranibizumab), or take a more selective approach and inhibit only VEGF165 (eg, pegaptantib sodium). Current guidance on their use is equivocal and restrictive at best, resulting in associated difficulties in securing adequate, timely funding for treatment. The Moorfields Eye Hospital undertook an audit of 70 patients receiving intravitreal (ITV) pegaptanib sodium on a pro re nata (prn) dosing schedule. Despite initial funding delays, the audit recorded superior treatment outcomes compared with those reported in the VISION trials at 12 weeks: 88% of audit patients maintained stable vision, 29% gained vision and 6% experienced severe vision loss compared with 70%, &ge;6% and &le;10% of patients in VISION at 54 weeks, respectively. The audit indicates a positive correlation between patients with better baseline visual acuity (VA) and improved therapeutic benefits, including a greater likelihood of both vision gain and vision preservation. Experience at Moorfields also suggests that pegaptanib sodium is more useful in occult lesions than minimally classic lesions, and clinical experience suggests that combination therapies may offer the best approach with anti-VEGF therapies. Further randomized clinical trials will help better determine the optimal treatment strategies with pegaptanib sodium in neovascular AMD.Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, pegaptanib sodium, visual outcomes, funding
format	article
author	Sobha Sivaprasad Nachiketa Acharya Phil Hykin
author_facet	Sobha Sivaprasad Nachiketa Acharya Phil Hykin
author_sort	Sobha Sivaprasad
title	Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
title_short	Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
title_full	Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
title_fullStr	Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
title_full_unstemmed	Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK
title_sort	pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the uk
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/5387f5b853cd417881facd7c3d727cf5
work_keys_str_mv	AT sobhasivaprasad pegaptanibsodiumforneovascularagerelatedmaculardegenerationclinicalexperienceintheuk AT nachiketaacharya pegaptanibsodiumforneovascularagerelatedmaculardegenerationclinicalexperienceintheuk AT philhykin pegaptanibsodiumforneovascularagerelatedmaculardegenerationclinicalexperienceintheuk
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Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK

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